The Social Cost of Nasal Sequelae in Patients with Cleft Lip and Palate in a Peruvian University Dental Clinic.

Abstract

Objective: To estimate the social cost of nasal sequelae in patients with cleft lip and palate (CL/P) treated in a Peruvian university dental clinic.

Methods: This is a cross-sectional study. The sample consisted of thirty patients over 18 years of age with nasal sequelae due to CL/P. This study conducted a partial economic analysis from a social perspective, by using the following questionnaires: ENAHO-Peru to assess sociodemographic variables, the Instituto de Salud del Niño - San Borja care guidelines and its tariff schedule to estimate health care costs, the Rhinoplasty Outcome Evaluation (ROE) scale to assess quality of life about the nasal sequela, and the "willingness to pay" (WTP) technique to calculate the monetary cost of the sequela from the patients' perspective. Costs in soles, where the exchange rate was: 1 USD = S/3.878.

Results: A total of 30 CL/P patients, who agreed to participate, were evaluated. Most of the patients were male (70.0%), aged 18-39 years (73.0%), single (93.4%), students (73.4%), and had secondary education (50.0%). Additionally, most were attended with Seguro Integral de Salud (46.7%), most had no daily income (50.0%), and the average quality of life score was 8.1. The highest direct cost reported was dental treatment (S/5756.89 ± S/359.22) and hospitalization (S/5013.60 ± S/880.15), statistically significant (p<0.05). The highest indirect cost was reported for absenteeism with a mean of 5288.6 ± 1280.23 (p<0.05). Regarding direct, indirect, and intangible costs in the treatment of nasal sequelae due to CL/P, the lowest median (S/6000.00) was found in intangible costs, with significant differences (p<0.05).

Conclusion: About half of the social cost (12,000 Peruvian soles = 3094 US dollars) was assumed by the patients, a prohibitive cost considering that most of them come from low socio-economic backgrounds.